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Capital Region hospitals say they're ready if there's a COVID-19 surge

Capital Region hospitals say they're ready if there's a COVID-19 surge

Critical bottleneck is gone — state will ratchet up to 6,000 tests a day next week
Capital Region hospitals say they're ready if there's a COVID-19 surge
Dr. David Liebers, chief medical officer of Ellis Medicine, speaks Friday at Albany Medical Center
Photographer: Erica Miller

ALBANY — New York made a huge leap forward Friday in its attempts to contain COVID-19, gaining authority to conduct 6,000 tests a day after being able to conduct a total of just 3,000 tests during the entire crisis, health officials said.

Gov. Andrew Cuomo announced Friday that federal regulators had eased limits on testing, eliminating the bottleneck that has existed as the caseload multiplied in the state. Later Friday, President Donald Trump announced a national state of emergency, which will provide additional resources to the state.

Cuomo said he’d spoken to Trump and Vice President Pence to request the new testing protocol, and then thanked them for expediting approval.

“We have the authorization as of today,” he said Friday. “So today the state Health Department will be going out to the 28 [private-sector] laboratories that the Department of Health works with on complex testing matters. And those 28 labs will be authorized to do testing. So, we are down in the boiler room now turning all the valves. The labs will be coming on.”

New York has the second-highest case count in the nation after Washington state. As of midday Friday there were 421 confirmed cases in New York, 96 more than a day earlier. The majority of new cases were in New York City. Two new cases were confirmed in Albany County and one in Schenectady County, bringing the Capital Region total to eight.

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On Friday, leaders of 10 hospitals from Hudson to Glens Falls and Troy to Amsterdam came together at Albany Medical Center to provide an update on what they are doing to prepare for the likely increase in infected patients, in an attempt to reassure the community that they are ready amid a period of public uncertainty and worry.

Dr. Dennis McKenna, incoming CEO of Albany Med, said the hospitals have created interdisciplinary teams of medical and non-medical personnel to prepare and the hospitals in daily contact with each other to coordinate their preparation and response — both individually and as a collective group with tens of thousands of medical professionals.

“It’s a very proud moment for health care delivery in this region,” McKenna said.

All the hospitals have planned what they’ll do in the event of a patient surge, but the greatest portion of their efforts now is aimed at trying to help ensure that surge doesn’t happen.

However, if there is a surge of patients sick with COVID-19, sometimes known by the generic name novel coronavirus, the hospitals will be able to respond.

“I’d say absolutely we have space for them, we just have to repurpose the space,” said Dr. David Liebers, chief medical officer of Ellis Medicine in Schenectady.

Operating rooms have negative-pressure ventilation, for example, and could be converted quickly to house one or even multiple infected patients in isolation.

WHY NOW?

The Gazette asked Liebers, an infectious disease specialist, why COVID-19 has prompted precautions unprecedented in modern times — far in excess of the SARS outbreak of 2003, which had a much higher mortality rate than COVID-19, or the H1N1 pandemic of 2009, which killed so many people.

Liebers said because it’s a new virus, the population has less immunity to it. Couple this with its apparent ability to spread easily, plus a higher death rate than seasonal flu, and it becomes a potentially major public health threat. 

“Viral diseases, although they look the same under the electron microscope, can vary widely based on the human immune system and what we call the virulence factor,” he said.

“Often, when a virus is new to human populations, a so-called novel virus, we are a little less prepared immunologically to fight it off. So it tends to be more transmissible, and often the morbidity can be more severe.

“SARS was an example of that, and ended up causing about a 10 percent mortality,” he said. “Pandemic flu, the most recent example of which was H1N1 in 2009, a little harder to know exactly where that was. Right now, we’re still figuring out where the coronavirus sits. I would say the mortality is more like pandemic flu [1 to 3 percent].”

Seasonal flu, meanwhile, is much more widespread but might have a mortality rate of only 0.1 percent. 

“We know that influenza will cause death, a small number in children, a greater number in the elderly and the infirm. But this is sort of on top of that. It’s as transmissible and the mortality rate is higher. I think one of the reasons [COVID-19] has caused appropriate concern is, if you do the numbers there could be a lot of deaths unless we mitigate things.”

Ellis Hospital hasn’t had a COVID-19 patient yet, but it is struggling with the impact nonetheless. A vendor unwittingly ill with the disease potentially exposed patients and staff there, sending a significant number of employees onto furlough and resulting in a number of elective surgeries being canceled Friday.

GETTING TESTED

Liebers, McKenna and the other hospital officials who gathered Friday said the limited availability of lab testing has been the biggest bottleneck so far in the response to COVID-19. Testing has had to be limited to patients authorized by a doctor or health department.

With all the new laboratories coming on line next week that should ease considerably. 

But until it does, patients should not just show up and request a test. They won’t get one.

The hospitals also are taking steps to separate people arriving with the respiratory symptoms that can indicate COVID-19 — or the seasonal flu, or just the common cold. Even during a public health crisis, hospitals need to serve all the other health needs of the community, from emergency appendectomies to arrival of newborn babies. Each coughing person who walks in without protective measures risks infecting other patients and medical personnel.

Albany Med and Saratoga Hospital have set up tents to interview and test respiratory patients as they arrive, Ellis Hospital is using a drive-through arrangement to test patients in their cars, St. Peter’s Health Partners is directing patients to an isolated building outside Albany Memorial Hospital, St. Mary’s Healthcare in Amsterdam has repurposed a former urgent care office with negative pressure ventilation and a drive-through loop outside, Glens Falls Hospital has put a trailer outside its building.

Dr. Rich Falivena, chief medical officer of Saratoga Hospital, said the response outlined Friday by the local hospitals has been a triumph of health care by the community for the community.

“I have to reiterate the spectacular response from our workforce. It truly is neighbors taking care of neighbors, and it is not ‘Can I help you?’ but ‘How much can I help you?’ We’re very proud of that. Every single day just makes me more proud to work in a community hospital like Saratoga.”

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